Beom Su Kim1, Seong Tae Oh1, Jeong Hwan Yook1, Byung Sik Kim2. 1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: bskim@amc.seoul.kr.
Abstract
BACKGROUND: The behavior of early stage signet ring cell carcinoma (SRC) is controversial. The purpose of this study was to clarify the behavior of early gastric SRC. METHODS: We retrospectively analyzed data from 2,085 patients who had undergone curative gastrectomy for early gastric cancer between 1989 and 2000. Clinicopathologic outcomes and prognoses were evaluated, and we investigated whether these variables were correlated with histopathologic type. RESULTS: Patients with early gastric SRC were younger and had a greater proportion of females than other histologic types. Lymph node metastasis was the only independent prognostic factor for both mucosal and submucosal forms of SRC. Mucosal SRC had a similar rate of lymph node metastasis to poorly differentiated (PD) tubular adenocarcinoma (TUB), and a higher rate than well-differentiated (WD) or moderately differentiated (MD)-TUB. However, its submucosal form had a similar rate of lymph node metastasis to WD-TUB, and a lower rate than MD- or PD-TUB. There was no difference in tumor recurrence or disease-related death according to histopathologic type or depth of invasion. CONCLUSION: In mucosal gastric cancer, SRC has an unfavorable risk factor of lymph node metastasis than that of others and should not be considered for endoscopic resection. In submucosal gastric cancer, SRC is a more favorable risk factor of lymph node metastasis than that of other histologic types.
BACKGROUND: The behavior of early stage signet ring cell carcinoma (SRC) is controversial. The purpose of this study was to clarify the behavior of early gastric SRC. METHODS: We retrospectively analyzed data from 2,085 patients who had undergone curative gastrectomy for early gastric cancer between 1989 and 2000. Clinicopathologic outcomes and prognoses were evaluated, and we investigated whether these variables were correlated with histopathologic type. RESULTS:Patients with early gastric SRC were younger and had a greater proportion of females than other histologic types. Lymph node metastasis was the only independent prognostic factor for both mucosal and submucosal forms of SRC. Mucosal SRC had a similar rate of lymph node metastasis to poorly differentiated (PD) tubular adenocarcinoma (TUB), and a higher rate than well-differentiated (WD) or moderately differentiated (MD)-TUB. However, its submucosal form had a similar rate of lymph node metastasis to WD-TUB, and a lower rate than MD- or PD-TUB. There was no difference in tumor recurrence or disease-related death according to histopathologic type or depth of invasion. CONCLUSION: In mucosal gastric cancer, SRC has an unfavorable risk factor of lymph node metastasis than that of others and should not be considered for endoscopic resection. In submucosal gastric cancer, SRC is a more favorable risk factor of lymph node metastasis than that of other histologic types.
Authors: Hyun Lim; In Seob Lee; Jeong Hoon Lee; Young Soo Park; Hyo Jeong Kang; Hee Kyong Na; Ji Yong Ahn; Do Hoon Kim; Kee Don Choi; Ho June Song; Gin Hyug Lee; Hwoon-Yong Jung; Jin-Ho Kim; Beom Su Kim; Jeong Hwan Yook; Byung Sik Kim Journal: Gastric Cancer Date: 2017-02-15 Impact factor: 7.370